Five countries, five ways to buy: how Nordic hospitals procure medical devices
Finland, Sweden, Norway, Denmark and Iceland are often treated as one market. For a medical device company, that is true for regulation: the MDR applies in all five, and Norway and Iceland follow the same procurement rules through the EEA Agreement. It is not true for buying. A device sold to public hospitals goes through five different systems, each with its own buyers, language and tender calendar. There is no joint Nordic device tender, so a contract won in one country is a reference in the next, not a sale.
One set of rules, five different buyers
Public hospitals must tender device contracts above the EU and EEA thresholds, which for regions and other sub-central buyers are EUR 216,000 from 2026. Who runs those tenders is where the countries part ways.
Norway has one national buyer, Sykehusinnkjøp HF, owned by the four regional health authorities.
Denmark's regions buy more and more together through Regionernes Fælles Indkøb (RFI).
Sweden's 21 regions mostly tender on their own.
Finland's wellbeing services counties buy through their own units, regional logistics companies, joint arrangements and Hansel, the national central purchasing body.
Iceland's national hospital, Landspítali, buys specialist devices for the whole country.
For a supplier, this changes the whole sales plan. In a centralised market, one tender can decide access to the country for several years. In a decentralised one, the same product has to win many smaller tenders, each with its own requirements and timing. A distributor that is strong with one type of buyer may be weak with the other.
The decision is made before the tender
In all five countries, clinicians take part in deciding what a device must do and how quality will be judged. Procurement then runs the process and evaluates the bids. By the time a tender notice is published, the specification and the scoring are fixed.
This is where many manufacturers lose. They prepare carefully for the tender itself but arrive after the requirements have been written around products the buyers already know. Timing matters as much as the product, and the right moment is different in each country.
Scoring varies more than most suppliers expect
EU law requires public buyers to award contracts to the most economically advantageous tender. That can mean the lowest price, the lowest life-cycle cost, or a combination of price and quality. How this is applied depends on the country, the buyer and the product. In Norway, for example, climate and environment must normally carry at least 30% of the score (Prop. 147 L), while many tenders elsewhere are still decided on price. A premium device and a low-cost alternative need very different strategies for the same tender.
What is changing in 2026–2027
Several changes affect suppliers in the next two years.
Finland: a procurement reform in force since June 2026 changes how larger contracts are divided and what happens when a tender receives a single bid.
Norway: amendments to the Public Procurement Act took effect on 1 July 2026, including a new provision on security and preparedness.
Denmark: Region Hovedstaden and Region Sjælland merge into Region Østdanmark on 1 January 2027, and a law on preparedness for medical devices introduces a state reserve.
Sweden: regions must hold stocks of healthcare products from 1 January 2027 (Socialstyrelsen).
Iceland: construction of the new national hospital is due to be mostly complete by the end of 2029, and its equipment will be tendered before opening (Ministry of Health).
EU: since June 2025, companies from China are excluded from device tenders of EUR 5 million or more.
Reforms and mergers can reopen existing contracts, and new supply-security rules add requirements that suppliers will have to price and plan for.
What HealthChain adds
Before entering a Nordic market, a manufacturer should be able to answer a few questions for each country. Which contract covers the product today, and when does it end? Who writes the specification, and when is it written? How have similar tenders been scored, and who won them? Which distributor has a track record with the buyers that matter?
Our Market Entry Snapshot answers these questions for a specific device and turns them into an entry order and a timetable. Through Distributor Search and Selection, we look for partners with a proven record in the relevant tenders, not only a sales network. When a project needs it, we work with independent specialists in hospital procurement.
If you are planning to sell to public hospitals in the Nordic countries, book a 30-minute call.
